2 days after laparoscopy. Pregnancy after laparoscopy

Unfortunately, not every woman can easily get pregnant, without problems and delays. Many gynecological diseases can become an obstacle in the desire to become a mother, but in such cases, medicine can help. Surgery using a laparoscope can be used both to eliminate the problem of the inability to become pregnant, and to treat gynecological pathologies. However, on the other hand, patients who have undergone this manipulation are interested in many questions: when can you try to get pregnant? What are the features of pregnancy after laparoscopy, will the operation lead to infertility?

The essence of laparoscopic surgery

Laparoscopy is a modern surgical method during which the operation is performed through three small incisions on the anterior abdominal wall. With the help of laparoscopy, operations are performed on the organs of the pelvic region and the abdominal cavity. Laparoscopy is also widely used in gynecology, since it can be used to operate on the uterus, ovaries and tubes.

The main instrument is the laparoscope, which is equipped with a video camera and a backlight, so the whole process can be observed on the monitor. Through the other two holes, various laparoscopic instruments are inserted. In order to increase the operational space, the abdominal cavity is filled with carbon dioxide. This leads to the fact that the stomach swells, the anterior abdominal wall rises, which forms a kind of dome over the internal organs.

Advantages and disadvantages of laparoscopy as a method

First of all, a very important fact is that during laparoscopy, the surgeon sees the internal organs much more accurately and much wider, since the area of ​​​​operation increases many times over. Other positives include:

the ability to simultaneously diagnose and surgically treat the pathology detected on it;

low probability of formation of postoperative adhesive processes;

the rehabilitation period is fast (bed rest is not required);

absence of rough scars, except for the places of suturing;

there are practically no pain sensations (the exception is the feeling of a feeling of fullness, until the time when the gas is sucked in, usually the first or second day);

short stay in the hospital (no more than three days);

minor blood loss;

low traumatism of organs (there is no contact with gauze swabs, air, gloves).

Disadvantages of laparoscopy include:

the impossibility of performing some operations using laparoscopy (suturing of blood vessels, removal of large tumors);

requires special skills or specially trained surgeons;

general anesthesia is required, which can lead to complications.

Examination before laparoscopy

Laparoscopy, like other surgical operations, requires a preliminary examination, which consists of:

taking a general blood test (with a leukocyte formula and platelets);

blood clotting test;

general analysis of urine;

gynecological examination of the patient on a special chair;

biochemical analysis of blood;

electrocardiography and fluorography;

ultrasound examination of the pelvic organs;

taking gynecological smears (from the urethra, cervix, vagina);

blood test for HIV infection, syphilis, hepatitis;

blood test for Rh factor and group;

if laparoscopy is performed for infertility, a partner needs to donate sperm for a spermogram.

Laparoscopic surgery is prescribed in the first phase of the cycle, approximately 6-7 days after the end of menstruation.

Indications for laparoscopy

Laparoscopy can be performed as an elective or emergency operation. Indications for immediate laparoscopic surgery are:

acute purulent inflammatory processes of the uterine appendages (myosalpinx, pyovar, tubo-ovarian formation);

torsion of the subserous node with uterine myoma or necrosis of the myomatous node;

torsion of the legs of an ovarian cyst;

rupture of an ovarian cyst;

ectopic pregnancy.

However, in most cases, laparoscopic surgery is performed as planned. The indication for this is:

diagnosis of secondary amenorrhea;

chronic pelvic pain of unknown etiology;

restoration of patency of the uterine tubes;

removal of the uterus (extripation and amputation), removal of the ovaries;

anomalies of the internal genital organs;

tubal infertility due to adhesions in the pelvis;

uterine fibroids (amputation of the uterus with its small size, removal of subserous nodes, myomectomy in the presence of multiple nodes);

genital endometriosis (endometriosis and adenomyosis of the ovaries);

polycystic ovaries;

tumor-like formations and various ovarian tumors;

temporary sterilization (clamping of the fallopian tubes with clips);

ligation of the fallopian tubes as one of the methods of contraception.

Contraindications

Laparoscopy, like laparotomy, also has a number of contraindications. Among the absolute contraindications are:

coma and shock of any etiology;

malignant processes in the pelvic organs, which have stage 2 and above with the presence of metastases;

insufficiency of the liver and kidneys;

coagulopathy (hemophilia);

hemorrhage in the brain;

diseases of the cardiovascular system, which are in the stage of decompensation.

In addition, laparoscopy may be prohibited for specific reasons:

obesity;

a smear from the vagina shows a 3-4 degree of purity;

pathological indicators of additional and laboratory diagnostic methods;

chronic or subacute salpingoophoritis (surgical treatment can be performed only in the presence of acute purulent inflammation of the appendages);

the presence of general chronic, acute and sexual infectious diseases, as well as in case of recovery that occurred less than 6 weeks ago;

inadequate and incomplete examination of spouses in case of infertility.

When can I get pregnant after laparoscopy?

The main issue of our article is to determine the moment after which you can actively plan and attempt to get pregnant. There is no unequivocal answer to this question, since much depends not only on the very fact of the operation, but also on the diagnosis that caused the surgical intervention. It is also worth considering the presence or absence of ovulation before the operation, the age of the woman, the difficulties that were present during the operation or in the postoperative period, the presence of concomitant gynecological pathologies, and so on.

After elimination of tubal obstruction (with tubal-peritoneal infertility)

If the purpose of the laparotomy was to eliminate the obstruction of the fallopian tubes, then the doctor allows you to plan a pregnancy no earlier than three months after the operation.

This is due to the fact that in the process of dissecting the adhesions of the fallopian tubes, they (the tubes) are pulled, after which the tubes are swollen for some time, therefore, it takes time for them to return to normal. In most cases, the swelling subsides within a month, but the body must recover after the intervention and normalize the functioning of the ovaries.

Obviously, the less time has passed since the dissection of adhesions, the higher the chances of conceiving a child. However, against the background of hyperemic and edematous tubes in a state of shock, there is a high probability of developing an ectopic pregnancy, which is why doctors advise to wait, and to alleviate the burden of waiting, monophasic oral contraceptives of combined action are prescribed for this time. Such an appointment not only prevents premature pregnancy, but also allows the ovaries to rest, which, after stopping the medication, begin to ovulate in an enhanced mode.

After cyst removal

If laparoscopy was performed for the presence of an ovarian cyst, it is also not worth rushing to get pregnant. Removal of an ovarian cyst by laparoscopic surgery is carried out very carefully. It is necessary to eject the cyst itself, and leave healthy tissues intact.

Functions of the ovaries can be restored within a month after the operation, however, doctors advise to postpone pregnancy for at least three months, and at best - for six months.

During this period, monophasic oral contraceptives are also prescribed, which relieve premature conception, allow the body to normalize hormonal levels, and relax the ovaries. If the pregnancy nevertheless came ahead of schedule, there may be problems with its course, so you need to be registered in the antenatal clinic in a timely manner.

After polycystic ovaries

A pathology in which many cysts form on the surface of the ovary is called polycystic ovaries. The operation to eliminate the pathology can be performed in three ways:

decortication - removal of a certain part of the compacted ovarian capsule;

wedge-shaped resection - excision of a part of the ovary together with the capsule;

cauterization - performing multiple notches on the capsule.

With polycystic after surgery, ovulation is restored for a short period (up to a year). Accordingly, pregnancy should be planned as early as possible, approximately 1 month after the operation, when sexual rest is canceled.

After an ectopic pregnancy

If laparoscopy is performed to eliminate an ectopic pregnancy, doctors prohibit pregnancy for 6 months (categorically), it does not matter whether the ovum was husked or tubectomy was performed. This period is necessary in order for the body to fully restore the hormonal background after an interrupted pregnancy. For six months, you need to protect yourself from re-conception and take hormonal drugs.

After endometriosis

Laparoscopy of endometriosis involves resection of the endometrioid cyst or dissection of adhesions, and simultaneous cauterization of foci of endometriosis on the surface of the organs and peritoneum. Pregnancy with endometriosis has a positive effect, because it prevents the growth and formation of foci. However, planning a pregnancy is still recommended 3 months after the intervention.

Most often, laparoscopic surgery is combined with the use of hormonal drugs, the course of which can be up to 6 months. In this case, pregnancy can be planned only after the end of the course of taking hormones.

After uterine fibroids

If a conservative laparoscopic myomectomy (removal of nodes with preservation of the uterus) has been performed, it takes time for the uterus to form rich scars. In addition, the ovaries also need rest in order to continue to function effectively. Due to these features, pregnancy planning is allowed, but not earlier than 6-8 months after surgery. A peculiar period of rest is supplemented by taking oral contraceptives and regular ultrasound of the uterus to monitor the healing process and scar formation.

If a premature pregnancy occurs, the uterus may burst along a scar that has not yet formed completely, which entails the complete removal of the organ.

Chances of getting pregnant after laparoscopy

The probability that a woman after laparoscopy will become pregnant within a year is 85%. After laparoscopy, pregnancy can occur in months:

after one month, a positive pregnancy test result is noted by about 20% of women;

within 3-5 months from the moment of the operation, about 20% of women also become pregnant;

after 6-8 months, pregnancy is registered in 30% of patients;

by the end of the year, pregnancy occurs in 15% of patients.

However, in 15% of women, pregnancy does not occur after undergoing laparoscopy. In such situations, doctors insist on IVF. After all, the chances of getting pregnant decrease depending on the time that has passed since the operation.

Rehabilitation after laparoscopy

Laparoscopic surgery is different in that the rehabilitation period (compared to laparotomy - dissection of the abdominal wall) takes much less time. By the evening after the operation, the woman can get out of bed herself, and discharge from the hospital is carried out after 2-3 days. Meals can be taken on the day of surgery, but they should be low-calorie and fractional.

If sutures were placed during the operation, they are removed after a week. Severe pain syndrome is most often absent, however, in the first days after surgery, arching pain may be present, which is explained by the introduction of gas during intervention in the abdominal cavity. After the gas is absorbed, the pain disappears.

Within 2-3 weeks, you should not lift weights (over 3 kg), avoid physical exertion. Sexual rest is observed for a month.

Menstrual cycle after laparoscopy

After a woman has undergone laparoscopy, as a rule, menstruation occurs on time, which indicates the normal functionality of the ovaries. Immediately after the operation, bloody and mucous discharge may appear in moderate amounts, which in principle is the norm, especially if the ovaries were operated on.

Bloody discharge can persist for up to three weeks, after which it turns into menstruation. In some cases, periods can be delayed from 3 days to 3 weeks. If the delay is longer, you should consult a doctor.

After removal by laparoscopy of an ectopic pregnancy, menstruation occurs in a month. In the first days after laparoscopy for an ectopic pregnancy, slight or even moderate spotting appears, which is normal in this case. These secretions are the result of rejection of the decidua (the place where the embryo is attached in the uterus) from the uterine cavity.

Preparing for pregnancy after laparoscopy

In order to increase the chances of conceiving a child and minimize the possible complications after pregnancy, first of all, you need to be examined:

visiting a gynecologist;

genetics consultation (preferably for all couples);

ultrasound examination of the organs of the reproductive system;

determination of hormonal status and correction of its violations;

smears from the urethra, cervix, vagina;

analysis for genital infections by PCR (if detected, it is necessary to treat them);

general clinical tests (urine, blood), if indicated, blood sugar levels and a biochemical blood test.

A more extensive examination, for example, an ultrasound of the mammary glands or a colposcopy, may also be needed. The expediency of such studies is determined by the doctor who observes the patient.

There are certain rules that must be observed when planning a pregnancy:

determine or calculate the days of ovulation and make active attempts to conceive on these days;

avoid stressful situations (if possible);

reconsider your diet in favor of a fortified and healthy diet;

lead an active, healthy lifestyle (moderate sports and physical activity, walks in the fresh air);

completely abandon addictions (both for the mother and father of the child);

take folic acid at least three months before a planned pregnancy.

Pregnancy after laparoscopy

If you observe the deadlines at the end of which pregnancy is allowed, as well as if all the recommendations are followed, pregnancy in most cases proceeds without complications. Any deviations that may distinguish the course from normal gestation are not associated with the fact of the operation, but with the disease that caused the need for the operation.

For example, if pregnancy after laparoscopy on the ovaries occurs earlier than three months, the risk of a premature termination of it in the early stages increases, due to the hormone-forming function of the ovaries. Thus, if such a situation arises, the doctor may prescribe antispasmodics and progesterone preparations in order to prevent miscarriage. It is also possible the development of other complications of gestation:

incorrect presentation and position of the fetus (during operations on the uterus);

placental insufficiency (infection, hormonal dysfunction);

placenta previa (due to the removal of myomatous nodes);

polyhydramnios (due to infection);

intrauterine infection against the background of chronic diseases of the genital organs of an inflammatory nature.

The course of childbirth

The postponed laparoscopy is not an indication for a planned caesarean section in the future, so childbirth should be carried out through the natural birth canal. The exceptions are operations that were performed on the uterus (reconstruction in case of anomalies in the development of the organ, removal of myomatous nodes), since after these manipulations scars remain on the uterus, which can cause a rupture at the time of childbirth. Complications of childbirth, which may not be associated with the operation, but with the reason for which surgical intervention was required (gynecological pathology):

postpartum subinvolution of the uterus;

early postpartum hemorrhage;

protracted childbirth;

birth anomalies.

FAQ

Six months ago I underwent a laparoscopy, and the pregnancy has not yet come, does this mean that the operation is ineffective?

Laparoscopic surgery is never ineffective. In any case, regardless of the reason for its implementation (ectopic pregnancy, cyst, polycystic), the doctor eliminated all the pathologies. Six months is a decent period in this case, but pregnancy can occur later, up to 12 months. The main task is to follow all the recommendations.

Why does pregnancy not occur after laparoscopy?

First you need to clarify the time that has passed since the operation. If it's been less than 12 months, don't worry. Maybe you need to conduct additional studies, donate blood for hormones, undergo an ultrasound of the pelvic organs. In some cases, the doctor may prescribe a detailed examination in order to establish the causes of infertility. It is likely that during the operation to remove the obstruction, anovulation is still present, or the matter is in the partner's sperm.

After the laparoscopic surgery, the doctor prescribed hormonal drugs. Is it necessary to take them?

Yes. Regardless of the reason that led to the need for surgery, it is necessary to take hormonal drugs. After all, they not only protect against premature pregnancy, but also allow the ovaries to relax and normalize the overall hormonal background.

Cystic ovarian formation in women is a common pathology in gynecology that doctors have to deal with. The modern method of laparoscopy allows to reduce the recovery time for patients and reduce complications in the postoperative period. Depending on how the recovery period passes, how all the doctor's recommendations are followed by the woman, not only her health depends, but also the ability to have children. You must follow the doctor's advice for recovery after laparoscopy.

The operation of laparoscopy of an ovarian cyst is easily tolerated by patients, and complications are rare in the postoperative period. The intervention is performed under general anesthesia. After coming out of anesthesia after 4-5 hours, the woman is allowed to get up and walk a little, and after three to four days the patient is discharged home. Such an early rise from bed after surgery is due to the prevention of the development of thrombophlebitis.

An important point in the further state of a woman's health is rehabilitation after laparoscopy. It is necessary to follow certain rules during this period so that this moment after the operation goes smoothly and without complications. The recovery period after laparoscopy is quite short and lasts about a month. During this month, a woman, following all the doctor's prescriptions, manages to fully restore her health.

Diet after laparoscopy

After discharge from the hospital, the patient must necessarily follow a diet, change her diet. Although laparoscopic surgery is less traumatic than open surgery, diet plays a big role in recovery.

The diet after laparoscopy of the ovarian cyst begins immediately after the woman comes out of anesthesia. On the first day after the operation, the body is given rest. It is allowed to use only water, you can use mineral water without gas. Gradually, on the second day after the operation, you can already eat solid food, but with restrictions.

A sparing diet is essential to unload the stomach and intestines. Due to inactivity, intestinal peristalsis slows down. This leads to congestion, possible constipation, heaviness in the stomach.

Nutrition after laparoscopy should be fractional, and portions should not exceed 200 grams. Meals are divided into 5 - 6 times. The following foods are excluded from your diet:

• Fatty beef and pork, salted lard;
• Canned fish and meat products;
• Spicy spices (pepper, garlic, onion);
• Pickled vegetables (cucumbers, tomatoes);
• Any smoked products (sausage, fish, meat);
• Legumes (peas, beans, lentils);
• Rich and sweet confectionery;
• From drinks - strong black tea, coffee, colored carbonated drinks.

When processing food, frying is excluded. Food is steamed or stewed without animal or vegetable fats.

What should be the table and what can you eat after laparoscopy of an ovarian cyst? The diet must include:

• Porridges cooked on water (buckwheat, millet, wheat, rice - with caution, as it can cause intestinal constipation);
• Soups in vegetable broth;
• Meat of chicken, turkey, rabbit in the form of steam cutlets or meatballs;
• Dairy products - low-fat cottage cheese, milk, low-fat kefir;
• From fruits - apples;
• From drinks - compotes, fruit drinks, kissels from fresh berries and fruits;
• Still mineral water.

In addition to following a diet after removal of an ovarian cyst, smoking should be abandoned for the entire period of rehabilitation. Alcohol after laparoscopy is categorically excluded in any form. The use of energy drinks, weak alcoholic beverages is not allowed. You must follow the doctor's advice for recovery after laparoscopy.

Disability after laparoscopy

The hospital stay for the duration of the operation is limited to three to four days. At this time, the patient is issued a certificate of incapacity for work, followed by observation and extension of the sick leave by a district gynecologist.

At the place of residence in the clinic, the doctor extends the sick leave for the duration of treatment for a period of 10-12 days. During this time, the patient's sutures are removed, the general condition and objective data are assessed. In the absence of complaints and the identification of positive dynamics, the patient is discharged to work with limited physical activity. In total, the sick leave after laparoscopy is 15-17 days.

Every woman who has undergone surgery is sure to be concerned about the question: how to quickly recover after surgery and move on to normal life and stress? In order for the quality of life to remain the same as before the operation, it is necessary to observe certain conditions during the rehabilitation period and follow the doctor's recommendations.

1. Limit physical activity. Only walks are shown. During physical exertion, the abdominal muscles tense up, which negatively affects the pelvic organs. Sports activities can be resumed no earlier than one month after the operation.
2. Limit heavy lifting, especially over three kilograms. Lifting weights is accompanied by tension in the abdominal muscles, resulting in increased pressure in the abdominal cavity. Vessel failure in the operated ovary can cause bleeding.
3. Exclude long trips in transport, driving a car.
4. Avoid air travel of any duration.
5. Postpone the adoption of water procedures in a bath, sauna, shower and bath at home until the sutures are removed on the surgical field. Up to this point, hygiene measures are carried out by rubbing the body with a sponge moistened with water. After removing the stitches, you can take a warm shower.
6. It is forbidden to visit the solarium, swimming in the river, lake or sea. It is better to start general water procedures at the end of the recovery period.

The implementation of all the doctor's recommendations will allow a woman to avoid complications after surgery and the development of a secondary infection.

Clinical symptoms of the recovery period

After removal of the ovarian cyst, discharge in a small amount of brown color may be observed. These are residual effects after surgery on the ovary. Brown discharge after laparoscopy can last up to two weeks. If the discharge acquires a different color or becomes abundant, it is necessary to consult a gynecologist in order to find out the cause of the pathological phenomenon.

During the recovery period, sexual intercourse is prohibited. In the absence of complications in the postoperative period, 4-6 weeks are enough for a woman's body to restore the anatomical integrity of the ovary. Only after this time are sexual contacts allowed.

Sex life after laparoscopy is always an individual question. After discharge from the hospital in the process of rehabilitation, not only the anatomical integrity of the organ is restored, but also its function. This takes time. Each woman has her own individual characteristics. Periods after laparoscopy of the ovary usually come on time, and in some women, there is a delay. Sometimes for one or two cycles. This period is considered normal. If the delay in menstruation after laparoscopy occurs for a longer time, the doctor prescribes corrective hormone therapy to stimulate ovulation.

To prevent complications and inflammation, antibiotics are mandatory after laparoscopy. Despite the sparing surgical intervention, there is a risk of complications in the postoperative period. It depends on the nature of the operated pathology, the individual characteristics of the woman, her age, concomitant chronic diseases, and the state of immunity.

In addition to antibiotics, to prevent the development of thrombophlebitis, as an inflammatory process in the vessel wall, it is recommended to wear compression stockings before and after surgery. A bandage after laparoscopy is another prophylactic for better fixation of the abdomen. Recommended for overweight women.

Often women complain that their stomach hurts after laparoscopy. In the first days after the operation, pain in the lower abdomen on the side of the operated ovary is possible. Pain syndrome occurs when an injury to the appendage, abdominal wall, internal organs during surgery. As a rule, the pain is tolerable, passing through 12 - 24 hours.

Sometimes there is pain in the neck, back with a return to the arm. This is due to carbon dioxide, which fills the abdominal cavity during the operation. There is irritation of the peritoneum, resulting in pain. Taking painkillers improves the condition of patients. Within a few days, carbon dioxide is absorbed and the pain disappears.

Thus, the postoperative period after laparoscopy will proceed without complications, and the restoration of health will occur as soon as possible if all the doctor's recommendations are followed and the diet is followed.

Laparoscopy- a modern, minimally invasive method of surgery, in which the surgeon makes several small holes in the abdominal cavity, with their help, the doctor performs diagnostic and therapeutic measures.

Currently, this type of access is used in the diagnosis of many diseases and is widely used, since it is less traumatic, requires a shorter recovery period, and does not leave scars.

Despite its advantages, laparoscopy is a surgical intervention, therefore, it has some limitations in the postoperative period. The patient requires special nutrition, hospital stay, restriction of physical activity. Carrying a child is stressful for the mother's body, therefore pregnancy after laparoscopy possible but after a certain amount of time after the operation.

Indications and contraindications

Another advantage of laparoscopy is the expansion of the surgeon's view, since special equipment is used during the operation, which magnifies the image by 20 or more times.

The disadvantages of laparoscopy include the complexity of its implementation, this operation requires special skills from the surgeon. With such an intervention, there is no sense of depth, the doctor's range of motion narrows. The laparoscopy specialist must have developed "non-intuitive" skills, since the blade of the instrument is directed in the opposite direction from the hands.

At the present stage of medicine, laparoscopy is used for many diseases, including gynecological ones. Planned operations of this type are used for the following pathologies:

• cysts, tumors, polycystic ovaries;
• proliferation of the epithelium of the uterus polyps;
• chronic pelvic pain;
• myoma, adenomatosis of the uterus;
• adhesive process in the fallopian tubes.

Rehabilitation after laparoscopy:

Postoperative period

It is recommended to get up at least 8 hours after the operation. and only when needed. Patients receive prophylactic therapy with broad-spectrum antibiotics. Postoperative sutures are removed after a week, until this time you should not take a bath, lift things more than 3 kilograms. It is not recommended to have sexual intercourse for 2 weeks, you can return to sports activities after a month.

The first day after laparoscopy is not recommended to eat, only water without gas is allowed. The next day, broths and soft cereals should be included in the diet. The first 5 days you need to limit the consumption of fresh vegetables and fruits, all food should be steamed. Within 1 month after the operation, it is not recommended to eat fried, smoked, spicy food.

Scars after 4 months from the date of laparoscopy:

Pregnancy after laparoscopy

Approximately 15% of women who undergo laparoscopy become pregnant a month later. Another 20% of patients manage to conceive a child in the interval from six months to a year after the operation. The rest of the women become pregnant within 2 to 6 months.

Attention! The time after which a woman should try to conceive a child depends on her condition and diagnosis, so she should follow the doctor's recommendations in this matter.

Planning a pregnancy after laparoscopy to remove an ovarian cyst should be no earlier than a month later, the exact timing depends on the condition of the woman. Usually, the organ resumes its functioning after a few days, but if this period is lengthened, attempts to conceive a child should be slightly postponed. With laparoscopy of the ovary for infertility against the background of polycystic, pregnancy should be planned in the next menstrual cycle. At later dates, there is a high probability of relapse.

With laparoscopy of endometriosis, the doctor cauterizes pathological areas in the uterine epithelium. For their healing, a certain period of time is required, it depends on the size of the focus and the localization of the process. On average, pregnancy planning after this intervention should be started after 2 months, more specific terms are determined by the doctor.

Planning for pregnancy after laparoscopic interventions for appendicitis, cholecystitis and other acute diseases should begin at least 2 months after the operation. The body must return to a physiological state after suffering a pathology that causes inflammatory reactions and changes in the functioning of all systems.

#one. Calculate ovulation. There are 2-3 days in the menstrual cycle when the egg is ready to fuse with the sperm. In order not to miss ovulation, a woman is recommended to use the calendar method, or a special test.

#2. Have sexual intercourse every 2 days. With too frequent intimacy, spermatozoa do not have time to accumulate in the right amount.

#3. Lead a healthy lifestyle. When planning a child, you should follow proper nutrition, stop using nicotine and alcohol.

#four. Do not get out of bed for 30 minutes after intercourse. When a woman is in a horizontal position, there is a high probability of sperm from the vagina entering the uterus and fallopian tubes.

Laparoscopy is a modern low-traumatic method for performing surgical interventions and diagnostic studies of organs located in the abdominal cavity and small pelvis.

The main stages of laparoscopy

• General anesthesia is used for laparoscopy. Small incisions are made on the skin (about two centimeters long), after which they are deepened with a blunt probe, thus preventing damage to the internal organs.
• One operation usually requires three to four holes. The introduction of sterile surgical instruments is carried out through special tubes inserted into the holes.
• To straighten the abdomen and provide maximum access to the internal organs, carbon dioxide is injected through one tube.
• A video camera and surgical instruments are inserted into other tubes.
• The video camera transmits the image of the operated organs on the monitor screen, which provides the doctor performing the operation with visual control over his actions.
• After all the necessary actions have been completed, the instruments are removed, sutures are applied to the incision site.

Chromotubation during laparoscopy

In the case of laparoscopy, in order to diagnose the patency of the fallopian tubes and determine the causes that prevent the onset of pregnancy, along with an external examination of the fallopian tubes during laparoscopy, chromotubation (chromohydrotubation) is performed.

The essence of chromotubation is the introduction of a sterile dye solution into the patient's uterus. In the absence of a violation of the patency of the fallopian tubes, a normal flow of the solution through the tubes is observed.

Benefits of laparoscopy

• Laparoscopy is characterized by little tissue trauma, unlike conventional operations, for which large incisions are made.
• The rehabilitation period after laparoscopy is easier and shorter. Within a few hours after laparoscopy, the patient is allowed to get up and walk.
• The risk of complications (infection of the wound, formation of adhesions, suture divergence) is significantly reduced.
• After laparoscopy, there are no large scars and scars.

Types of laparoscopic operations

Laparoscopy is used for surgical interventions aimed at removing or restoring the affected organs. To date, using this method, the following operations are carried out:

• remove the gallbladder (for patients with cholecystitis and gallstone disease);
• remove the appendix;
• remove the kidneys, bladder and ureter, or restore their functions;
• remove or ligate the fallopian tubes (sterilization);
• remove an ectopic pregnancy;
• treat endometriosis;
• treat PCOS (polycystic ovary syndrome);
• carry out hernia treatment;
• perform surgical interventions on the liver, stomach and pancreas;
• examine and remove ovarian cysts;
• remove uterine fibroids;
• remove the adhesive process in the fallopian tubes;
• Diagnose and stop internal bleeding.

Preparation for laparoscopy

Preparation for laparoscopic surgery is discussed by the doctor and the patient on an individual basis. The following actions are recommended:

• refusal to eat 8 hours before the intervention;
• setting a cleansing enema a few hours before the operation;
• epilation of the abdomen (if laparoscopy is performed for men).

Before the operation, the patient must tell the doctor about the medications he is taking. Due to the influence of certain drugs (aspirin, contraceptives) on hemocoagulation, their use before laparoscopy is strictly contraindicated.

Possible complications after laparoscopy

Laparoscopy is a method characterized by a minimal risk of dangerous complications. As a rule, this operation is easily tolerated, recovery after laparoscopy is fast.

Seek medical attention after discharge from the hospital as soon as possible if the following symptoms appear:

• high fever, chills;
• fainting (loss of consciousness);
• increased pain in the abdomen, nausea, vomiting that does not stop for several hours;
• swelling, suppuration or redness in the area of ​​the seams;
• bleeding from wounds;
• urination disorders

Recovery period after laparoscopy

Most often, the patient recovers within a few days after laparoscopy, sometimes he can even be discharged on the day of the operation.

After laparoscopy, the patient may complain of intense pain in the abdomen and in the area of ​​postoperative wounds, aggravated by movement. This is considered normal. Pain relievers may be prescribed to relieve pain.

In some cases, there may be bloating, nausea, general weakness. To eliminate severe bloating, drugs are prescribed, which include simethicone.

Feeling of weakness, nausea, loss of appetite and increased urge to urinate disappear on their own after 2-3 days after laparoscopy.

Stitches after laparoscopy

Due to the small size of the incisions made for laparoscopy, they heal in a short time, complications develop in extremely rare cases.

Sutures are removed 10-14 days after laparoscopy, in some cases earlier. During the first months, small purple scars are observed at the site of the incisions, which should fade over time and become invisible.

Diet after laparoscopy

A few hours or the entire first day after laparoscopy, you must refuse to eat. Non-carbonated mineral water is allowed.

On the second or third day, easily digestible foods are introduced into the diet: fat-free kefir, yogurt, crackers, unsaturated broth, lean meats, fish, rice porridge are allowed.

Returning to the usual diet depends on the patient's well-being.

Physical activity after laparoscopy

The first two to three weeks after the laparoscopic surgery, the patient should limit any physical activity and sports. The return to the normal rhythm of life should occur gradually.

Sex life after laparoscopy

Sexual intercourse after surgery can be resumed after 7-14 days, after consulting with a doctor if laparoscopy was performed for gynecological diseases.

Periods and discharge after laparoscopy

After a laparoscopic operation aimed at treating or diagnosing diseases in the field of gynecology, there may be scanty mucous or bloody vaginal discharge, which can last 10-14 days. This is not a cause for concern.

Fear can cause the appearance of strong bloody vaginal discharge, as they may indicate internal bleeding.

After laparoscopy, there may be a violation of the menstrual cycle: menstruation may not occur on time and may be delayed for several days or weeks. This is also considered normal.

When to plan pregnancy after laparoscopy

Laparoscopy is often prescribed as a diagnostic and therapeutic method for diseases that are accompanied by infertility (endometriosis, fibroids, adhesive processes, ovarian cysts, polycystic ovary syndrome, fallopian tube reconstruction, etc.). If the operation was successful, you can plan a pregnancy already a few months after the operation.

Due to the fact that not only surgery is used to treat infertility, but also conservative therapy, which involves taking medications that affect female reproductive function, pregnancy planning should be discussed with the attending physician who has studied the patient's medical history.

The successful onset of pregnancy depends on what factors caused infertility before treatment, as well as on how effective the treatment was.

Rehabilitation after laparoscopy is much faster and easier than after strip surgery. The modern minimally invasive method of endoscopic surgery can significantly reduce the time of tissue and organ regeneration. Thus, discomfort after laparoscopy is minimized.
However, recovery after laparoscopy is still necessary. Its duration depends on the type and complexity of the operation, the individual characteristics of the patient. Some feel good after a few hours, for others the process stretches for a couple of weeks.

The first 3-4 days after laparoscopy are the most critical. Most patients spend these days in the hospital.
After the operation, sutures and an aseptic bandage are applied to the injection sites of laparoscopes. Wounds are treated every day with a solution of brilliant green or iodine. The sutures are removed on the 5th - 7th day.
To restore the tone of the abdominal muscles, stretched from the introduction of carbon dioxide into the abdominal cavity, a bandage is needed. Sometimes a drainage tube is installed to drain the ichor. After a couple of days, an ultrasound examination of the pelvic organs is performed to track the dynamics of healing.
The postoperative bandage is applied for 2-4 days. It cannot be removed. It is recommended to rest on your back. If the patient feels well, he is not disturbed by stitches and a drainage tube is not installed, he can sleep on his side. Lying on your stomach is strictly prohibited.
The first hours are the hardest. The patient moves away from the action of anesthesia and is half asleep. Chills, a feeling of coldness are possible.

Also often there are:

• moderate pulling pains in the lower abdomen;
• nausea;
• vomit;
• dizziness;
• frequent urge to urinate.

These are normal postoperative symptoms that go away on their own. If pain is severe, anesthetics are indicated.

Additional Information! A normal symptom also includes discomfort in the throat - it appears as a result of the introduction of an anesthetic tube. In addition, on the 2nd day after laparoscopy, pain in the shoulder and cervical region often occurs - the sensations are explained by gas pressure on the diaphragm.

After laparoscopy, recovery is quick and easy. Usually the patient's health is satisfactory, and complications are rare. Basically, they are provoked by the patient's non-compliance with the doctor's recommendations.

How long to stay in the hospital and temporary disability

The recovery period for each after laparoscopy is different. Some may go home as soon as the anesthesia wears off. Others take 2-3 days to recover.
However, doctors strongly recommend spending the first day in the hospital. This is the most critical period in which complications can develop.
How long you can get up is determined individually. Usually after 3-4 hours the patient can walk a little. Movements should be as careful and smooth as possible. Walking is necessary - this normalizes blood flow and the waste of carbon dioxide, prevents thrombophlebitis and the formation of adhesions.
But the main mode should be bed. Most of the time you need to lie down or sit. After a couple of days, when you can get up without fear, walking along the hospital corridors or in the courtyard of the clinic is recommended.
Usually, patients are discharged after 5 days if there are no complications and complaints. But full recovery takes 3-4 weeks. Not only the scars should heal, but also the internal organs should heal.
Sick leave is issued for 10-14 days. If complications are noted, then the disability sheet is extended on an individual basis.

Features of nutrition in the recovery period

The first day after the laparoscopy operation, it is forbidden to eat. When the anesthesia wears off, you can drink clean still water.
You can eat after the operation on the second day. Food should be liquid and at room temperature. Low-fat broths, yogurts, kissels, fruit drinks, compotes are allowed.

On the third day include:

• porridge on the water;
• fermented milk products - kefir, cottage cheese, yogurt, low-fat cheese;
• easily digestible fruits and berries without peel - apples, bananas, apricots, strawberries, melons and others;
• steamed vegetables - zucchini, peppers, carrots, eggplants, beets, tomatoes;
• seafood;
• boiled eggs;
• whole wheat bread;
• dietary meat and fish in the form of minced meat dishes.

By the end of the week, restrictions are reduced to a minimum. Within a month, in the recovery mode after laparoscopy, exclude from the diet:

1. Fatty, spicy, smoked food. The meat is baked, cooked in a double boiler or slow cooker. Soups are made without frying. Prohibited sausages, fatty fish, canned food, marinades, pork. Preference is given to chicken, rabbit, turkey, veal.
2. Products that provoke gas formation. Exclude legumes (beans, peas, lentils), raw milk, muffins (white bread, buns, any homemade cakes), confectionery.
3. Alcohol and carbonated drinks. It is allowed to drink weak tea, fruit drinks, compotes, mineral water without gas. It is better to refuse juices, especially store-bought ones, as they contain citric acid and sugar. For a month, any alcoholic beverages are completely prohibited. Also, after laparoscopy, it is desirable to exclude coffee - starting from the second week, you can only drink weak coffee without cream.

Important! As for cigarettes, doctors have no consensus. Some categorically prohibit smoking for 3-4 weeks, as nicotine and heavy metals slow down regeneration and provoke bleeding. Others believe that a sharp rejection of a bad habit and the resulting withdrawal syndrome, on the contrary, can aggravate the patient's condition.

During the entire rehabilitation, especially in the first few days, nutrition should be fractional. You need to eat in small portions 6 - 7 times a day. It is necessary to monitor the regularity and consistency of the stool.
Make up a balanced and complete diet. Food should contain all the necessary vitamins, minerals, elements. The exact diet is selected by the attending physician, taking into account the specific disease and the individual characteristics of the patient.

What can be taken and why

Surgery is only one of the stages of therapy. Therefore, after laparoscopy, medical treatment is indicated. Usually written out:

1. Broad spectrum antibiotics. Necessary to prevent the infectious and inflammatory process.
2. Anti-inflammatory, enzymatic and wound healing medicines. They are needed to prevent scars, adhesions and infiltrate - a painful seal that forms at the site of surgical intervention. For this purpose, after laparoscopy, the ointment "Levomekol", "Almag-1", "Wobenzym", "Kontraktubeks", "Lidaza" is most often prescribed.
3. Immunomodulatory drugs - "Immunal", "Imudon", "Likopid", "Taktivin".
4. Hormonal preparations. Shown to normalize the hormonal background, if laparoscopy was performed in women due to gynecological diseases - adnexitis (inflammation of the uterine appendages), endometriosis (abnormal growth of cells of the inner layer of the uterus), with hydrosalpinx (obstruction of the fallopian tubes),. Longidase, Klostilbegit, Duphaston, Zoladex, Visanu are prescribed in the form of suppositories, injections for injections, less often tablets and oral contraceptives. You need to drink OK after laparoscopy within six months.
5. Vitamin complexes. Recommended for general body support.
6. Painkillers. "Ketonal", "Nurofen", "Diclofenac", "Tramadol" and others. Discharged for severe pain.
7. Means based on simethicone. Needed to eliminate gas formation in the intestines and bloating. Most often, "Espumizan", "Pepfiz", "Meteospazmil", "Disflatil", "Simikol" are prescribed.

Also, after laparoscopy, you can drink drugs that reduce blood clotting and prevent the formation of blood clots - Aescusan, Aescin. They are necessary to prevent thrombosis.

Basic rules of conduct during the rehabilitation period

After discharge from the hospital, the patient must strictly observe the following recommendations after laparoscopy:

• treat the stitches with antiseptics every day and change the dressings;
• do not try to remove the seams on your own or violate their integrity in any other way;
• do not remove the bandage until the abdominal muscles recover - usually it is worn for 4, maximum 5 days;
• means for resorption of scars can not be used earlier than 2 weeks after laparoscopy;
• alternate rest with physical activity - walking, household chores;
• a month after the operation, follow the diet developed by the doctor;
• take prescribed medications in accordance with the prescribed course - a couple of weeks or several months;
• drink vitamin complexes;
• wear comfortable clothes that do not squeeze, do not overtighten or rub.

To speed up recovery, to prevent the appearance of scars and adhesions, physiotherapy is indicated after surgery. Most often, magnetic therapy is recommended. If laparoscopy was performed for diagnostic purposes, then physiotherapy is not prescribed.
Also, you can not overheat, take a hot bath, stay in the sun for a long time, as high temperature can lead to internal hemorrhage. When it is possible to go to the sea or to the bathhouse, the attending physician determines after passing control tests. If they are normal and the patient's condition is satisfactory, they allow a trip to a resort or a visit to the sauna a month after laparoscopy.
To recover faster after laparoscopy, all doctor's instructions must be strictly observed. If you ignore the advice, then the development of complications or a relapse of the disease is possible.

Sports activities during the recovery period

Since full rehabilitation lasts at least a month, it is necessary to limit physical activity. The following are under the ban:

• gymnastics, fitness, callanetics, yoga;
• workouts in the gym;
• swimming;
• dancing.

From physical activity after laparoscopy refrain from 4 to 6 weeks. You can not somehow load the muscles of the abdominal cavity. Only leisurely walks in the fresh air are allowed. How much to walk, the patient determines individually, based on his well-being. It is recommended to walk no longer than half an hour at a time. It is important that the patient avoids rough terrain - beams, ravines, etc. The road should be flat, without descents and ascents.
A month and a half after laparoscopy, you can enter physical exercises. It is necessary to start playing sports gradually, weekly increasing the load.
A simple set of exercises should be gradually introduced - turns, tilts, leg swings. Then more difficult classes are included. It is allowed to work with a load (dumbbells, weights) or on simulators no earlier than 1.5 - 2 months after laparoscopy.

What not to do after laparoscopy

Since the body recovers for a long time after any surgical intervention, it is necessary to refrain from increased stress. Including with laparoscopy - a number of restrictions are imposed in the postoperative period. Among them:

• you can not lift weights weighing more than 2 kg;
• it is necessary to minimize housework - cleaning, cooking;
• it is necessary to limit any labor activity, including mental;
• it is forbidden to take a bath, visit the bathhouse, solarium, swim in the pool and pond;
• flights, long trips by car, bus, train are excluded;
• sexual abstinence is imposed for a month, especially if laparoscopy was done to a woman on the pelvic organs;
• any sports activities - only walking is allowed.

It is also necessary to carefully carry out hygiene procedures. There are no direct contraindications, but it is better to limit yourself to wiping with a damp sponge. It is allowed to take a warm shower, if you close the seams with a waterproof bandage and do not rub the wounds with a washcloth.

Additional Information! It is forbidden to touch seams and scars in any way: comb, rub, peel off dried crusts.

The speed of rehabilitation directly depends on how the patient will behave. Negative consequences occur extremely rarely if the patient follows all the recommendations of the doctor.

Symptoms requiring a visit to a specialist

In the postoperative period, a number of symptoms appear. Some of them are considered normal for rehabilitation, others indicate the development of possible complications.
The standard consequences of the recovery period after laparoscopy are:

1. Flatulence. It occurs as a result of the introduction of carbon dioxide into the abdominal cavity, which is needed for a better view. To remove its manifestations, special medications are prescribed, it is recommended to adhere to a diet that reduces gas formation, and to observe moderate physical activity.
2. General weakness. Typical for any surgical procedure. Drowsiness develops, rapid fatigue. They go away on their own in a few days.
3. Nausea, lack of appetite. This is a common reaction to the introduction of anesthesia.
4. Pain at the incision site. They are aggravated by movement and walking. After tightening the wounds go away on their own. If the sensations are severe, painkillers are prescribed.
5. Pain in the abdomen. They can be pulling or aching in nature. Appear in response to damage to the integrity of internal organs. Gradually subside and completely disappear within a week. Anesthetics are recommended for relief.
6. Vaginal discharge. Appear during the operation of the pelvic organs in women. An ichor with small impurities of blood is considered normal.
7. Extraordinary periods. If a woman has an ovary removed, unscheduled menstruation is possible.

Abnormal outcomes of laparoscopy that indicate a complication include:

1. Severe pain in the abdomen. It is worth worrying if they do not go away, intensify, are accompanied by an increase in temperature.
2. Copious discharge from the genital tract. Severe bleeding, discharge with blood clots or pus indicate the development of negative consequences.
3. Fainting.
4. Swelling and suppuration of the seams. If after laparoscopy the wound does not heal, oozes, an infiltrate appears from it, and its edges are dense and red, it is necessary to inform the doctor. This indicates the accession of infection and the development of an infiltrate.
5. Violation of urination.

Also, such consequences include severe intoxication of the body. It is expressed as:

• nausea and vomiting that do not go away for several hours;
• a temperature that does not drop for a couple of days is above 38 ° C;
• chills and fever;
• severe weakness and drowsiness;
• sleep and appetite disturbance;
• shortness of breath;
• cardiopalmus;
• dry tongue.

Note! Any non-standard consequences and sensations should be reported to the doctor immediately. They indicate the development of serious complications. Self-treatment is unacceptable.

The rehabilitation period after laparoscopy is easier and faster than after conventional abdominal surgery. However, like any surgical intervention, it affects the functioning of organs and general well-being. Therefore, restrictions are imposed on sports, travel, outdoor activities, and the use of certain products for a month. In addition, it is necessary to follow all the doctor's recommendations: attend physiotherapy procedures, take prescribed medications.